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[]Confidential Report fl Route Route Only As Marked [ ] DE Needed *Return Originals To: <br />CHIEF <br />CPT <br />East <br />CPT <br />West <br />Supt <br />Capt <br />INV. <br />P/O <br />SUPPLEMENTAL REPORT <br />EUGENE POLICE DEPARTMENT <br />RELATED REPORTS <br />❑ Incident <br />o <br />Page of <br />Viol <br />Prop <br />Fin <br />spec <br />safer <br />[NET <br />Crimes <br />Crimes <br />Crimes <br />Inv <br />Schools <br />--- <br />Accident <br />❑ station <br />❑ Prop /Evidence <br />❑ Supplemental <br />Brief 2 <br />Down- <br />town <br />DPS <br />EDU <br />Arson <br />Fire <br />1. Incident <br />�_ <br />2. Case Number <br />City <br />Pros <br />Muni <br />Court <br />Circuit <br />Court <br />Juv <br />Court <br />I.A. <br />Risk <br />Paro <br />Prob <br />DHS <br />Vic <br />Sery <br />CAC <br />Med <br />Exm <br />Crim <br />Anys <br />Oper <br />Anys <br />3. Location <br />4. Grid <br />5. Source <br />Mental <br />Trf�r <br />Health <br />SDS <br />Postal <br />I <br />OLCC <br />DMV <br />En g <br />S. Rept. Date <br />7, Time 8. <br />lo2 <br />Occurred Date <br />to <br />9. Ti a <br />to <br />Seq. # <br />Pat <br />Asgn <br />Other <br />'0 ' <br />FOLLOW-UP REPORT <br />El <br />• Victtcompl First <br />Middle <br />-j6Q <br />12. DOB <br />DISPOSITION REPORT ❑ 13. <br />Subject of Arrest/Disposition <br />14. DOB <br />15. ❑ CLEARED BY ARREST ❑ CLEARED EXCEPTIONAL ❑ CLEARED UNFOUNDED <br />❑ SUSPENDED <br />16. ❑ NO ADDITIONAL INFORMATION ❑ NO CRIME WAS COMMITTED <br />17. Incident Reclassification <br />18. REFERRED TO: <br />19. REVIEWING PROSECUTOR: <br />PERSONS <br />VEHICLES PROPERTY <br />MISCELLANEOUS <br />AI <br />Arrested <br />01 <br />Operator AV/ Abandoned Veh API Abandoned Prop <br />All Additional Info <br />LU1 Line -up Viewed <br />BI <br />Cited (UTC) <br />PI <br />Parent E/ Evidence EI Evidence <br />AO/ Assisting Officer <br />MO/ Modus Operandi <br />CI <br />Complainant <br />RI <br />Reg Owner IV/ involved Veh FP/ Found Prop <br />BC/ Bias Crime <br />MS/ Mug Shots Taken <br />DI <br />Dual -Vitt & Camp! <br />S1 <br />Suspect LVI Locate /Susp Veh IPI Involved Prop <br />BO/ Breathalyzer Opr. <br />PT/ Photos Taken <br />GI <br />Passenger <br />T1 <br />Contacted Mvl Missing Veh MP/ Missing Prop <br />CHI Charges <br />RC/ Related Cases <br />HI <br />Non- Criminal Hold <br />VI <br />Victim RV/ Recovered Veh RP/ Recovered Prop <br />CITI Citations Issued <br />RF/ Rolled Fingerprints <br />I1 <br />Involved/Not Cont <br />W1 <br />Witness SVI Stolen Veh 5P1 Stolen Prop <br />DC/ Duplicate Copies <br />RMD/ Recommended Follow -Up <br />V <br />Legal Owner <br />Y/ <br />Wanted Subj TV/ Towed Veh VP/ Victim Prop :: <br />DD/ Document Desc <br />SCDI Susp Code Detail <br />MI <br />Cited (Misd) <br />WI Victim Veh DPI Damaged: Prop <br />IS/ Injuries Sustained TC/ Towing Company <br />LFI Latent Fingerprints VOI Video Operation <br />LRl Lab Results <br />VCDI Vehicle Code Detail <br />20. R ing Officer ID# 21. Reporting Officer ID# 22. Date & Time Prep ed 23. ve y ID# <br />� Imo- ea;2_0 3 0 J� <br />SUPPLEMENTAL 11 -28 -11 <br />